Related Experiment Video
Updated: May 6, 2026
04:57
Establishing a Competing Risk Regression Nomogram Model for Survival Data
Published on: October 23, 2020
10.7K
Risk-Based vs Annual Breast Cancer Screening: The WISDOM Randomized Clinical Trial
Laura J Esserman1, Allison S Fiscalini1, Arash Naeim2
1University of California, San Francisco.
JAMA
|December 12, 2025
Summary
Risk-based breast cancer screening stratified women by genetic risk and screening intensity. While safe, this approach did not decrease biopsy rates compared to annual mammography.
Area of Science:
- Oncology
- Genetics
- Preventive Medicine
Background:
- Individual breast cancer risk assessment can optimize screening strategies.
- Current screening methods may not efficiently allocate resources to high-risk individuals.
Purpose of the Study:
- To evaluate the feasibility of risk-based breast cancer screening as an alternative to annual mammography.
- To determine if risk stratification improves screening outcomes.
Main Methods:
- A pragmatic, multicenter randomized clinical trial compared risk-based screening with annual mammography in women aged 40-74.
- Risk assessment involved genetic sequencing, polygenic risk scores, and a validated risk model.
- Screening recommendations varied based on calculated 5-year risk and genetic factors.
Main Results:
- Risk-based screening was noninferior for detecting stage ≥IIB cancers but did not reduce biopsy rates compared to annual screening.
- Fewer mammograms were performed in the risk-based group, yet biopsy rates were not significantly lower.
- Cancer incidence, biopsy, mammogram, and MRI rates increased with higher risk categories.
Conclusions:
- Risk-based breast cancer screening, incorporating genetic testing, effectively stratified risk and screening intensity.
- This approach did not lead to a reduction in biopsy rates.
- Further research may be needed to optimize risk-based screening protocols to reduce unnecessary biopsies.
Related Concept Videos
02:59Cancer Prevention
6.5K
Several factors can increase the risk of cancer in an individual. About 50% of cancer cases can be prevented by adopting a healthy lifestyle, regular exercise, eating healthy, and following a modest cancer prevention diet. Epidemiological studies have consistently shown that populations with vegetable and fruit-rich diets have reduced the incidence of cancer. On the other hand, populations who have a diet rich in animal fat, red meat, junk food, or high calories are predisposed to cancer.
Some...
Some...
6.5K
01:16Clinical Trials
8.5K
Clinical trials are prospective experimental studies conducted on humans to determine the safety and efficacy of treatments, drugs, diet methods, and medical devices. Using statistics in clinical trials enables researchers to derive reasonable and accurate conclusions from the collected data, allowing them to make wise decisions in uncertain situations. In medical research, statistical methods are crucial for preventing errors and bias.
There are four phases in a clinical trial. A phase one...
There are four phases in a clinical trial. A phase one...
8.5K
01:11Clinical Trials: Overview
4.7K
Clinical development focuses on how the drug will interact with the human body and encompasses four key phases of clinical trials, each serving a specific purpose in assessing the safety and effectiveness of new drugs. These phases overlap and build upon one another. Phase I involves a small group of healthy volunteers (typically 20-80 individuals) or, in cases where significant toxicity is expected, patients with the targeted disease, such as cancer or AIDS. The volunteers are tested for...
4.7K
01:12Relative Risk
2.5K
Relative risk (RR) is a statistical measure commonly used in epidemiology to compare the likelihood of a particular event occurring between two groups. This metric is important for evaluating the relationship between exposure to a specific risk factor and the probability of a particular outcome. It plays a crucial role in medical research, public health studies, and risk assessment. Relative risk quantifies how much more (or less) likely an event is to occur in an exposed group compared to an...
2.5K
01:21Cancer Survival Analysis
870
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
870
01:12Hazard Ratio
786
The hazard ratio (HR) is a widely used measure in clinical trials to compare the risk of events, such as death or disease recurrence, between two groups over time. It reflects the ratio of hazard rates—the instantaneous risk of the event occurring—between a treatment group and a control group. This measure provides valuable insights into the relative effectiveness of a treatment by assessing how the risk of an event differs between the two groups.
For example, in a clinical trial...
For example, in a clinical trial...
786